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Social workers and real therapy.

As a licensed clinical social worker and a film buff, I look forward to Dr. Roland Atkinson's columns, which are thoughtful and clinically interesting, but I was disappointed in his review of the film "Prime" ("Rx: Visit Your 'Mother' Once a Week," Reel Life, December 2005, p. 20).

I found disturbing his tone in talking about "a master's-prepared clinical social worker," the role played by Meryl Streep.

Dr. Atkinson did not explicitly identify social workers as "therapist-mamas," but he did state that "there are many master's-prepared therapists (mostly women) who conduct practices significantly devoted to mothering dependent clients."

This statement, coupled with the identification of Ms. Streep as an LCSW in the film, made the implied connection evident; i.e., clinical social workers (and other master's-prepared therapists) don't do real psychotherapy, but rather foster dependence in their clients who just want to be loved.

I'm sure Dr. Atkinson knows that many, many licensed clinical social workers are psychodynamically trained and practice in a way that might even meet the standards of psychiatry.

I have known many LCSWs during the course of my career who are Jungian analysts, psychodynamic psychotherapists, and depth psychologists, none of whom would consider the mama therapy he describes as helpful or able to create character change. And most of us other mental health professionals know that it doesn't require a medical degree to be a good psychotherapist.

Maybe I'm just feeling a bit touchy, but I do get tired of being lumped with lousy therapists. I have a 2-year master's degree from 1 of the top 10 social work master's programs in the United States (University of California at Berkeley).

I trained for 2 years at the Psychotherapy Institute in Berkeley, a post-master's program for the study of analytic psychotherapy and have worked in private practice for many years--not as a mama, but as an honest-to-goodness psychoanalytic psychotherapist.

As we know from our work, tone is crucial in getting the message across. I hope Dr. Atkinson's message was not meant to denigrate the many licensed clinical social workers who do admirable and depth-oriented work.

Despite this one review, I continue to look forward to Dr. Atkinson's film reviews!

Kate Pinney

Eugene, Ore.

Dr. Atkinson replies:

I very much regret it if the tone Ms. Pinney infers in my article on the film "Prime" comes through as one of condescension toward, or veiled criticism of, master's-prepared psychotherapists. I meant no such thing. In fact, I thought the thrust of my arguments was in precisely the opposite direction; i.e., I was trying to defend the sort of supportive therapy evinced in the film. I will confess that my style in that article was rather breezy. I often choose a style for a column that I think resonates with the tone of the film itself. "Prime," after all, was an irreverent comedy, or at least it attempted to be that. Perhaps there is a risk that breeziness will be equated by some readers with something more insidious.

Let me be as clear as I can about my "prejudices" toward psychotherapists, as I do indeed have some. I think the ideal therapist is someone who is considerate and compassionate--whose own capacity for intimacy is not badly compromised or scarred: someone with a good heart; who has a good intellect; who is flexible (not inexorably wedded to some dogma or orthodoxy); and who has a solid grounding in psychodynamics, interpersonal, and existential methods, crisis management and practical problem solving, and at least the informal use of cognitive-behavioral and rational-emotive approaches. It should go without saying that such a therapist will have also experienced significant amounts of personal therapy. Notice that I have made no reference to degrees or affiliations with any institutions. A good therapist can have any sort of degree. As far as I know, Jay Haley, one of my psychotherapist heroes, still has only a bachelor's degree. The flip side is that within each specific professional legion, as in all vocations, there are superior, average, and mediocre (but at least marginally proficient) practitioners.

Some therapists are limited in range: They work well with some people, poorly with others. I think a patient (client) is fortunate indeed--often lucky even--to get matched up with a really good therapist. I always encourage someone I am referring to another therapist to "shop." I try my best to suggest three therapists I think will match up well, but still encourage the individual to visit all three for a single session before choosing, seeking the right fit.

I thank Ms. Pinney for making the effort to write. These are important issues.
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Title Annotation:LETTERS
Publication:Clinical Psychiatry News
Article Type:Letter to the editor
Date:Mar 1, 2006
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